Challenges and contributing factors in glucocorticoid treatment adherence among patients with oral lichen planus: a cross-sectional study and management strategies

To investigate the status of glucocorticoid treatment adherence in patients with oral lichen planus (OLP), identify its influencing factors using validated instruments, and propose a targeted management framework incorporating behavioral insights and digital health strategies. A cross-sectional study was conducted among 116 OLP patients recruited from our hospital between January 2021 and December 2023. The study protocol was approved by the Hospital’s Ethics Committee (Approval No: 20201215), and written informed consent was obtained from all participants. Data were collected using a general information questionnaire, the Chinese version of the 8-item Morisky Medication Adherence Scale (MMAS-8), and a self-designed OLP knowledge questionnaire. Exploratory factor analysis was performed to validate the MMAS-8 structure. Multivariate logistic regression was used to identify independent predictors of poor adherence. The rate of poor adherence was 63.8% (74/116). Factor analysis confirmed a two-dimensional structure of non-adherence (unintentional and intentional). Multivariate analysis identified age ≥ 50 years, disease duration ≥ 3 years, recurrence frequency ≥ 3, glucocorticoid side effects, and rural residence as independent risk factors for poor adherence (all P < 0.05). Higher education level and household income served as protective factors. Poor treatment adherence is prevalent among OLP patients and is influenced by multidimensional factors. The behavioral distinction between unintentional and intentional non-adherence provides a critical basis for precision management. We recommend an integrated strategy combining structured education, side-effect–optimized regimens, and digitally enabled follow-up to address adherence challenges and improve long-term outcomes.